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Review
. 2020 Dec;9(4):182-188.
doi: 10.15420/aer.2020.09.

Management of Cardiac Sarcoidosis in 2020

Nisha Gilotra  1 , David Okada  1 , Apurva Sharma  1 , Jonathan Chrispin  1
Affiliations
Review

Management of Cardiac Sarcoidosis in 2020

Nisha Gilotra et al. Arrhythm Electrophysiol Rev. 2020 Dec.

Abstract

Sarcoidosis is an inflammatory granulomatous disease that can affect any organ. Up to one-quarter of patients with systemic sarcoidosis may have evidence of cardiac involvement. The clinical manifestations of cardiac sarcoidosis (CS) include heart block, atrial arrhythmias, ventricular arrhythmias and heart failure. The diagnosis of CS can be challenging given the patchy infiltration of the myocardium but, with the increased availability of advanced cardiac imaging, more cases of CS are being identified. Immunosuppression with corticosteroids remains the standard therapy for the acute inflammatory phase of CS, but there is an evolving role of steroid-sparing agents. In this article, the authors provide an update on the diagnosis of CS, including the role of imaging; review the clinical manifestations of CS, namely heart block, atrial and ventricular arrhythmias and heart failure; discuss updated management strategies, including immunosuppression, electrophysiological and heart failure therapies; and identify the current gaps in knowledge and future directions for cardiac sarcoidosis.

Keywords: Sarcoid; arrhythmias; cardiac sarcoid; heart failure; immunosuppression.

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Conflict of interest statement

Disclosure: JC is the recipient of the Robert E Meyerhoff Professorship. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Haematoxylin and Eosin Staining of Native Explanted Heart Tissue of a Patient Undergoing Heart Transplantation
Figure 2:
Figure 2:. Cardiac MRI with Late Gadolinium in Patients With Cardiac Sarcoid
Figure 3:
Figure 3:. 18F-Fluorodeoxyglucose PET Imaging
Figure 4:
Figure 4:. Late Gadolinium Enhancement on Cardiac MRI and Electrophysiological Testing
Figure 5:
Figure 5:. 18F-Fluorodeoxyglucose PET Imaging
See this image and copyright information in PMC

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